Organization
UNITED WOUND HEALING PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN P DIRKS PA (CEO)
(855) 255-1750
Entity
Organization
Contact information
Practice address
413 29TH ST NE STE I, PUYALLUP, WA 98372-7154
(855) 255-1750
(855) 255-0905
Mailing address
413 29TH ST NE STE I, PUYALLUP, WA 98372-7154
(855) 255-1750
(855) 255-0905
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
—
—
207P00000X
Emergency Medicine Physician
—
—
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208600000X
Surgery Physician
Primary
—
—
213E00000X
Podiatrist
—
—
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669845327
—
ID
05
—
2054899
—
WA
05
—
3005543
—
UT
05
—
4326555
—
TX
05
—
500738702
—
OR
Enumeration date
11/03/2015
Last updated
04/28/2025
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